基于达标理论的出院准备服务在颈脊髓损伤患者中的应用效果  

Application effect of discharge preparation service based on theory of goal attainment on patients with cervical spinal cord injury

作　　者：魏岚[1] 卢锴璇 康永生[2] 陈丽丽[1] 赵宁 Wei Lan;Lu Kaixuan;Kang Yongsheng;Chen Lili;Zhao Ning(Department of Nursing,Zhengzhou Orthopedic Hospital,Zhengzhou 450052,China;First Department of Spine Surgery,Zhengzhou Orthopedics Hospital,Zhengzhou 450052,China;Outpatient Department of Livable Health Town Campus,Zhengzhou Orthopedic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州市骨科医院护理部,郑州450052 [2]郑州市骨科医院脊柱骨科Ⅰ,郑州450052 [3]郑州市骨科医院健康城院区门诊,郑州450052

出　　处：《中华创伤杂志》2024年第2期173-178,共6页Chinese Journal of Trauma

基　　金：河南省医学科技攻关计划省部共建备选项目(2018010046)。

摘　　要：目的探讨基于达标理论的出院准备服务在颈脊髓损伤患者中的应用效果。方法采用回顾性队列研究分析2017年1月至2022年12月郑州市骨科医院收治的60例颈脊髓损伤患者的临床资料,其中男49例,女11例;年龄23~79岁[(52.2±13.5)岁]。患者均行颈椎减压融合内固定术。2017年1月至2019年12月入院的患者接受常规护理(常规护理组,30例);2020年1月至2022年12月入院的患者接受基于达标理论的出院准备服务进行护理干预(出院准备服务组,30例)。出院前4 h采用出院准备度量表(RHDS)比较两组出院准备度。干预前、出院时及出院后6个月采用日本骨科学会(JOA)评分比较两组脊髓功能障碍程度。出院后6个月比较两组并发症发生率及非计划再入院率。结果患者均获随访6个月。出院前4 h出院准备服务组RHDS个人状态、适应能力、预期性支持三个维度得分及总分分别为(20.9±3.5)分、(35.9±2.2)分、(30.4±3.0)分、(87.1±7.8)分,均高于常规护理组的(16.2±1.7)分、(32.5±2.2)分、(26.3±2.1)分、(75.0±5.6)分(P<0.01)。干预前两组JOA评分差异无统计学意义(P>0.05)。出院时及出院后6个月出院准备服务组JOA评分分别为(11.8±1.7)分、(13.8±1.5)分,均高于常规护理组的(10.3±1.8)分、(11.6±1.9)分(P<0.01)。出院后6个月出院准备服务组并发症发生率为6.7%(2/30),低于常规护理组的36.7%(11/30)(P<0.05)。出院后6个月出院准备服务组非计划再入院率为3.3%(1/30),低于常规护理组的23.3%(7/30)(P<0.05)。结论基于达标理论的出院准备服务可提高颈脊髓损伤患者的出院准备度、促进脊髓功能恢复、降低并发症发生率和非计划再入院率。Objective To investigate the application effect of discharge preparation service based on theory of goal attainment on patients with cervical spinal cord injury.Methods A retrospective cohort study was conducted to analyze the clinic data of 60 patients with cervical spinal cord injury admitted to Zhengzhou Orthopedics Hospital from January 2017 to December 2022,including 49 males and 11 females,aged 23-79 years[(52.2±13.5)years].Patients were all treated with cervical decompression fusion and internal fixation.Patients admitted from January 2017 to December 2019 were treated with conventional nursing intervention(conventional nursing group,n=30)and patients admitted from January 2020 to December 2022 were treated with discharge preparation service based on theory of goal attainment(discharge preparation service group,n=30).The readiness for hospital discharge of the two groups was compared using the Chinese version of Readiness for Hospital Discharge Scale(RHDS)at 4 hours before discharge.The degree of cervical spinal cord dysfunction of the two groups were compared using Japanese Orthopedic Association(JOA)score before intervention,at discharge and at 6 months after discharge.The complication and unplanned readmission rates of the two groups were compared at 6 months after discharge.Results All the patients were followed up for 6 months.At 4 hours before discharge,the scores of the three parameters of RHDS containing personal status,adaptability and anticipatory support and the total score of the discharge preparation service group were(20.9±3.5)points,(35.9±2.2)points,(30.4±3.0)points and(87.1±7.8)points respectively,higher than those of the conventional nursing group[(16.2±1.7)points,(32.5±2.2)points,(26.3±2.1)points and(75.0±5.6)points respectively](P<0.01).There was no statistically significant difference in the JOA score of the two groups before intervention(P>0.05).The JOA scores of the discharge preparation service group at discharge and at 6 months after discharge were(11.8±1.7)points and(13.8

关 键 词：颈椎 脊髓损伤 病人出院 护理 

分 类 号：R473.6[医药卫生—护理学]